Video Supporting_file_01[1]

Video for CA was defined as positive when all of the following three criteria were met upon observation of the LES performed with the attached ST Hood short-type: a) Congestion inside the hood, b) ischemic change around the hood, and c) palisade vessels outside the hood

Prone Position Is Useful in Thoracoscopic Enucleation of Esophageal Leiomyoma

A 36-year-old man was admitted to our institute due to the diagnosis of esophageal submucosal tumor detected by a periodical upper gastrointestinal endoscopic examination without any complaint. Thoracoscopic enucleation of the lesion with the preoperative clinical diagnosis of esophageal leiomyoma was performed under general anesthesia in the prone position. After immunohistochemical examination, the pathological diagnosis was leiomyoma. There was no remarkable event during the postoperative hospital stay, and the patient was discharged on the 12th day after surgery. This case report suggests that the prone position might be superior to the left lateral decubitus position in thoracoscopic enucleation of esophageal leiomyoma

Data from: New endoscopic finding of esophageal achalasia with ST Hood short type: corona appearance

Background and Study Aims: Detecting esophageal achalasia remains a challenge. We describe the diagnostic utility of corona appearance, a novel endoscopic finding specific to esophageal achalasia. Patients and Methods: Corona appearance and seven conventional endoscopic findings were compared for sensitivity and consistency (-value) among 53 untreated esophageal achalasia patients who underwent endoscopy at our hospital. The following criteria had to be met during lower esophageal sphincter examination using the attached ST Hood short-type for positive corona appearance: A) congestion inside the hood, B) ischemic change around the hood, and C) palisade vessels outside the hood. Results: Corona appearance had the highest sensitivity (91%; -value, 0.71). Other findings in descending order of sensitivity included 1) functional stenosis of the esophagogastric junction (EGJ; 86%; -value, 0.58), 2) mucosal thickening and whitish change (71%; -value, 0.27), 3) abnormal contraction of the esophageal body (59%; -value, 0.32), 4) dilation of the esophageal lumen (58%; -value, 0.53), 5) liquid remnant (57%; -value, 0.51), 6) Wrapping around EGJ (49%; -value, 0.14), and 7) food remnant (30%; -value, 0.88). Even in 22 patients with poor (grade 1) intraluminal expansion, corona appearance had highest sensitivity (88%) compared to other endoscopic findings (-value, 0.63). Conclusions: Among endoscopic findings using a ST Hood short-type to diagnose esophageal achalasia, corona appearance had the highest sensitivity and its consistency (-value) among endoscopists was substantial compared to other endoscopic findings. Similar results were obtained for esophageal achalasia cases with poor expansion. Endoscopic diagnosis of esophageal achalasia with hood attached is useful

Gastric metastasis from salivary duct carcinoma mimicking primary gastric cancer

Introduction: We present a very rare case of gastric metastasis mimicking primary gastric cancer in a patient who had undergone surgery for salivary duct carcinoma. Presentation of case: A 67-year-old man had been diagnosed as having right parotid cancer and had undergone a right parotidectomy and lymph node dissection. The histological diagnosis was salivary duct carcinoma. One year after the surgery, a positron emission tomography–computed tomography scan using fluorodeoxyglucose (FDG) revealed an abnormal uptake of FDG in the left cervical, mediastinal, paraaortic, and cardiac lymph nodes; stomach; and pancreas. On gastroduodenoscopy, there was a huge, easily bleeding ulcer mimicking primary gastric cancer at the upper body of the stomach. Biopsy revealed poorly differentiated adenocarcinoma. Therefore, we were unable to differentiate between the primary gastric cancer and the metastatic tumor using gastroduodenoscopy and biopsy. Because of the uncontrollable bleeding from the gastric cancer, we performed an emergency palliative total gastrectomy. On histological examination, the gastric lesion was found to be metastatic carcinoma originating from the salivary duct carcinoma. Discussion: In the presented case, we could not diagnose the gastric metastasis originating from the salivary duct carcinoma even by endoscopic biopsy. This is because the histological appearance of salivary duct carcinoma is similar to that of high-grade adenocarcinoma, thus, resembling primary gastric cancer. Conclusion: When we perform endoscopic examination of patients with malignant neoplasias, a possibility of metastatic gastric cancer should be taken into consideration

New endoscopic finding of esophageal achalasia with ST Hood short type: Corona appearance - Fig 2

<p>CA was defined as positive when all of the following three criteria were met upon observation of the LES performed with the attached ST Hood short-type: a) Congestion inside the hood, b) ischemic change around the hood, and c) palisade vessels outside the hood.</p

General clinical features of patients with achalasia.

<p>General clinical features of patients with achalasia.</p

Endoscopic findings in esophageal achalasia.

<p>a: Functional stenosis of the esophagogastric junction. b: Wrapping around the esophagogastric junction. c: Abnormal contraction of the esophageal body. d: Mucosal thickening and whitish change. e: Dilation of the esophageal lumen. f, g: Liquid and/or food remnant.</p

General sensitivity and κ-value of endoscopic findings in achalasia.

<p>General sensitivity and κ-value of endoscopic findings in achalasia.</p